Why Openness About Mental Illness is Worth The Effort And Discomfort

Last week I was having a bad day — nothing tragic, just adult life's vicissitudes — when I got an email from a complete stranger that knocked me on my ass.

I'll call this guy John. John recently survived a brush with suicidal depression and anxiety. John's story is both terrifying and inspiring because he faced that depression without a job, without medical insurance, and (until he reached out for help) without a support network, and came out on the other end. John took a leap of hope, sought help from a loved one, got treatment, and got through the crisis. Is he happy all the time? I doubt it. Who is? But he's managing the illness successfully and living his life.

John thanked me for writing openly about my experiences with severe depression and anxiety and how they have changed my life. He expressed a sentiment that I also experienced as a powerful deterrent to getting help: the fear that medication, or hospitalization, and therapy somehow mark you as other and lead to the end of your plans and ambitions forever. It's not true. It helps, John said, to see other people who have fought mental illness, taken the plunge into serious treatment, and come out the other side continuing to pursue their careers and families and lives. John thanked me for writing, and said I made a difference for him and helped him imagine recovery as a possibility. I'm going to remember that on my worst days, when I'm down on myself.

People who have fought mental illness — people who are still struggling with it, every day — can change people's lives by offering hope.

Depression and anxiety are doubly pernicious. They don't just rob you of your ability to process life's challenges. They rob you of the ability to imagine things getting better — they rob you of hope. When well-meaning people try to help, they often address the wrong problem. "Your relationship will work out if you just talk," or "I'm sure your boss doesn't actually hate you," or "things will look up and you'll find another job" may all be true, and may all be good advice. But they don't address the heart of mental illness. A depressed or anxious person isn't just burdened with life's routine problems. They're burdened with being unable to think about them without sheer misery, and being unable to conceive of an end to that misery continuing, endlessly, in response to one problem after another. Solving the problems, one by one, doesn't solve the misery.

The hope you can offer to someone who is depressed or anxious isn't your problems will all go away. They won't. That's ridiculous (though certainly it's much easier to solve or avoid problems when you're not debilitated). The hope you can offer is this: you will be able to face life's challenges without fear and misery. The hope isn't that your life will be perfect. The hope is that after a day facing problems you'll still be able to experience happiness and contentment. The hope is that you'll feel "normal" again.

You can make a difference. You can be open about how you've fought depression and anxiety. You can talk about how you felt hopelessness. You can talk about how you reached the point where you got help. You can describe how you had doubts about the point of getting help, too. You can talk about how getting help has changed your life — even if the process hasn't been smooth. You can convey to people out there that they aren't alone, that other people have felt the way they feel, that there is life and love and fun and success and normality following treatment for serious mental illness, and that it's achievable. You can spit in the face of the social stigma against mental illness and its treatment. You can defy the trolls and assholes who will mock you and use your openness against you — because what's their opinion worth, anyway? You can show that it's possible to get better even if you're broken, flawed, afraid. You can show that a setback isn't the end of the road to getting better. You can help them understand there's no magic instant cure, that recovery can be a lifelong process.

Your — you personally, not the collective you — can make a difference. It might be your story that connects with someone, that helps them imagine getting better. It might be someone in your social circle who is suffering and doesn't know anyone else talking about these issues. It could be your take on this process that tips the balance towards treatment for someone you've never met or heard of. Your story counts. Tell it.

Here are just a few who have made a difference — to others, and to me — through their openness about depression and anxiety, with links to what they've said. You're not famous like them, you say? Good. That means you're more relatable and your story may resonate more with folks. It will be embarrassing (though it shouldn't be) and awkward (at first, at least) and some loser will probably take a cheap shot at you, but it's worth it. Try it. And please join me in thanking and admiring these people for their openness:

Comments

I'm just a nym in the world, but I had a very bad time with depression.
I managed for years on my own without help, but then things got to be to much.
I could tell you this spiraling story of my descent, but thats not how operate.
(Being a secretive nym means I edit out identifiable information)
It got bad enough that I wasn't leaving the house, hell somedays I didn't get out of bed.
I tried to pretend it wasn't as bad as it was, but it was that bad.
I talked with a friend who got me to promise (after months of talking & supporting me) to tell the Doctor about my depression. And there I sat in the exam room and it just came pouring out. The replaying of every mistake I've ever made consuming my thoughts & feeding the feelings that I'm just not worth it.
Zoloft has been amazing.
I will probably be on it or another drug for the rest of my life. It takes some fine tuning, my first round improved things for me some but I wasn't even back to the level before it crashed down. The dosage was upped, and for the first time in decades I feel better.
I'm not sure if I feel like "normal" people do, but I feel better. This might be my normal, I'm not sure. I was depressed for so long, I'm not sure if I was ever "normal".
I can interact with people in person and not feel taxed and drained afterwards.
10 minutes of social interaction shouldn't leave you feeling so drained & tired you have to take an hour nap.
Its not the be all end all, I probably have other work & issues to get sorted out… but I can now think about doing that rather than it just feed depression shoving me deeper into the dark.
And this has been to much sharing for me… k bai thks.

I've worked in the applied sciences and tech manufacturing since the 1990's. One day in the early 21st century, there was an accident and I was hit with a chemical splash. The idea that I was going to die and it wasn't my fault and I wouldn't be shaming my parents by committing suicide brought me transcendent joy, the first positive emotion I had felt in years.

Your descriptions here are wonderful, and I wish I had come across something like that when I was dealing with similar problems myself. So much advice I seeked out had maintaining optimism as a sort of prerequisite. That's quite obvious to me now, but would be inconceivable then. It's very lonely when it seems you're the only one with that problem, and why it's so great to see it become more acceptable to be open about it.

Yeah, take away the loved one (I have no family whatsoever) and treatment, and I'm John. I was unemployed from the beginning of February to the beginning of June. I could barely afford rent, food, utilities, and one tiny credit card bill, and all the rest of my bills went unpaid. I was behind on rent, my cats were sick, my unemployment was about to run out, and, of course, the depression I've fought my entire life had returned with a vengeance. The only reason I'm still here is a) true or not, my dad drilled into me that suicide is for cowards (i don't agree, but it's something to hold onto when it's bad), and b) while I may die to a disease, I absolutely WILL NOT be DEFEATED by one. Those kept me going out of pure stubbornness until I finally got a job offer and started turning things around.

Honesty, however, compels me to admit that if I owned a gun, I would probably not be here today. It was that bad.

And yes, I understand completely what Argentina Orange was saying. There were quite a few times in those four months I would have welcomed a fatal accident – some way to die that wouldn't have been suicide.

Thank you, Ken. You and others (including most of those you named — though I'd also like to note that Dick Cavett and Carrie Fisher both wrote about depression in ways that specifically made me get treatment) have helped me, and I try to do the same to others, especially young friends suffering, who I hope won't have to entirely go through what I did most of my adult life.

I went through something very similar to John, except it was the depression gene kicking in after I got physically injured, lost my job, house, marriage–even my dog died. The kids unfriended me on Facebook. The depression was just a nice little bonus on top of everything else, and its timing was impeccable. Murphy's law is a bitch.

Going through that kind of stuff is practically impossible without depression. The mental and physical are intertwined and you can't have one without the other. You can't get better physically without the right mindset, and you can't get better emotionally when you are in poor physical health. When you have neither, being a normal person again seems unobtainable.

Depression is a funny thing because you feel all alone, even though for most people, all the love and support they need is right there. At least that was the case for me. My first instinct was to think that I had a long, healthy and productive life that most people would be lucky to have, but it was probably just time for me to go. It's easy to do in poor health, too, because there's no official act of suicide–you just stop caring for yourself and biology takes care of the rest.

When I was finally ready to entertain the idea that, okay, maybe I still have a few good years left, I opened my eyes, looked around, and everything and everyone I needed was right there waiting for me to make the first step. It wasn't an easy journey to put it fucking mildly, but I ended up in a great place with people who love me. Now in a healthy mental state, about the only thing I miss from my previous life is the dog. I could take or leave the stressful job and the fancy house with fake friends. So, part of overcoming depression for me meant letting go of all the unimportant shit.

Anyway, thanks, Ken, for being awesome and doing justice to a normally taboo subject. You nailed it! Only good things can come from more dialog.

I'm am constantly thankful that self-harm isn't among the catalog of horrors that my depression has caused me to visit upon myself over the years. I've been lower than low at times, but for whatever reason, that's not a journey my mind takes.

When I finally hit rock-bottom, the awareness that I had built my life solely around work and family and didn't have a single friend I felt I could call (much less talk about my somewhat unusual circumstances) was pretty difficult to accept.

The days now are much better days even though there's so much more I want to do and I feel the time is slipping away.

In conjunction with still-regular talk therapy, Welbutrin seems to manage me; Lexapro was an absolute disaster (as in not a full night's sleep for more than 30 days).

Thank you so much for this. I do not have a mental illness but do have a close family member with one. I think your advice to tell people that they WILL be able to deal with their depression and anxiety is really great. Most people who want to help don't know what to say, and say what they think would be comforting: that the problems will get better. But as you point out, their biggest challenge isn't the problems, bad as they may be, but the dread that they will never, ever be able to deal with them. That is really wonderful advice.

This is the recurring theme in writings about depression. "Get help." "There are people who want to help you." "I got help." "I finally asked for help."

And that's the part that always hurts the most. You don't expect it to be a magic bullet. You don't think you'll talk to someone, or take a pill, and suddenly everything will be better. But you also don't expect the doctor to roll his eyes and say, "All pregnant women are depressed." You don't expect your therapist to say, "You just need some 'me time.' Go out and get some ice cream, and you'll feel better." You sure don't think that, after seeking your pastor's advice, you'll overhear his secretary gossiping about how you shouldn't have any more kids if you can't handle the ones you have. (Yeah, apparently severe depression = bad parent.)

So far, I've reached out to supposed professionals SIX TIMES. Each time I was mocked, belittled, ignored, or minimized. I'm currently trying for the seventh time. Maybe those who are supposed to be the help should be told that's what they're supposed to be.

But I'm depressed and I like mashed potatoes. But seriously, it's a decent analogy. Thanks Ken, and everyone else, for helping to offer a little bit of hope for those of us (like myself) who are still struggling to stay afloat. Thank goodness for pills and the love of my family (especially my wife), without which I'd probably have died at least a couple of times over.

Back in the days of IAD/Craig and Chance, that amusement was literally the only thing keeping me "grounded" as my life and depression/anxiety (which was not just the usual one two punch of those two disorders, but throwing PPD into the mix made the whole thing even worse) spiraled out of control. I too was unemployed and uninsured and I've spent the last 2 years trying to crawl out of that deep whole that I spent the previous 2 years living (and desiring death) in (which I suppose is part of why I became an almost non-existent member of this community, especially compared to how active I was before my PPD hit hard)
If it wasnt for people like you or Allie Brosch being open about your experiences, I wouldn't have sought the help I needed, not would I have had the courage to be open about my struggles. Through my battle is far from over, I am at least employed (something I would never have been able to do 2-4 years ago) and living a happier life. I've also had people reach out to me and thank me for my openness, because it helped them feel less alone in their mental health struggles.

So, I guess, add my name to the list of people who are grateful and have been positively effected by your openness with your mental health struggles. Thank you.

You can make a difference. You can be open about how you've fought depression and anxiety. You can talk about how you felt hopelessness. You can talk about how you reached the point where you got help. You can describe how you had doubts about the point of getting help, too. You can talk about how getting help has changed your life — even if the process hasn't been smooth. You can convey to people out there that they aren't alone, that other people have felt the way they feel, that there is life and love and fun and success and normality following treatment for serious mental illness, and that it's achievable.

actually, I can't really do any of that. Got any suggestions that don't involve more general 'fighting of societal stigma'?

This is so right on. Your message of hope and life beyond the diagnosis is so important. I thank God for a breakdown that was in actuality a break THROUGH and a path to wholeness that I am still following today. BRAVO.

When you reach out, and are told by a licensed psychologist, no less, that you are lazy, irresponsible, and that all your problems (and those of the people around you) are actually due to you…

When you reach out, and your family–whom you know loves you–continue to ask you if you are 'cured' yet (and/or offer their 'solutions' to your 'issues')…

When your work environment is such, you know your personal business–and yeah, sorry, my mental health issues are my personal business–will be gossip fodder the moment you try to use work resources to manage your depression…

I don't suffer from depression myself, but I care about and for people who do. It's very meaningful to me when you and people like you write about your experiences with depression, because it helps replenish my hope too. Sometimes it's hard to be empathetic when you're the person who has to pick up the pieces from a loved one's illness; when folks like you write, I can gain a little perspective and hopefully be a better friend, family member, and partner.

I suffered from something remarkably like depression; in fact, this particular thing let whatever depression existed permeate my life. I would be riding down a freeway on my motorcycle, looking at underpasses, trying to judge which one would guarantee death should I "accidentally" crash into it. I was all about accidental death, assuming that insurance companies don't cover suicide in their life insurance policies.

The treatment for transgender persons is pretty close to the same type of treatments given for depression, and the experience of being lifted out of the hole you're in is very much like that of escaping the deep bouts of depression people can be subjected to.

I hate to be a downer here, but I would caution that talking openly about one's mental health struggles is also a great way to be silently judged, discriminated against, and face lost opportunities.

I appreciate that you've been brave enough to speak about your struggles with depression. For those who are in a position to take this risk, the benefit to others is undeniable.

Nevertheless, I really can't recommend this to most people. Attorney White is a partner in his own firm and is a mid-career attorney with a history of accomplishments under his belt. Not everyone is in a position of such independence.

I would probably say I suffer from 'depression lite' in that I don't get dragged down by the undertow, but the current does smack me around for a while and leaves me exhausted but free of the drag down that so, so many people get into. But I can understand Ken's impassioned advice as well, and I know the dangers and potholes that accompany it. I do understand the thoughts of just ending things, and when I was younger, especially in high school where things got their roughest for me, I did try. Unlike Taliesyn though, it's not through determination that I overcome this desire, but something akin to cowardice in that I can not do things that intentionally harm me. It's weird, but it's kept me plodding along.

I do wonder about something though. For those who suffer through depression, is it natural to put all the blame on oneself? Every time one of these bouts hit, suddenly it seems that every minor thing that goes wrong in my life, no matter what the circumstance, is suddenly 100% my fault. Is this normal? Or is this more akin to how I was brought up?

And then there's the utterly asinine policy of the DoD, that being treated for mental illness makes you a security risk. You're required to report it as such if you or any of your co-workers are being treated for mental illness (HIPPA? What's that?) IF you self-report, and IF the security office thinks your condition is being 'properly managed', you might get to keep your security clearance–that little thing that allows you to hold down a job as a defense contractor, without which you are worthless baggage to your defense contractor employer. That's a lot of 'ifs' for something that could cost you your livelihood if you get it treated. If you don't bother to get it treated, there's no record, no paper trail, no security risk flag…

@Dragoness – This policy torpedoed my dream of working at the State Dept. I had an episode of major depression in college, sought treatment, and eventually took a temporary leave before I finished my degree elsewhere. I wanted badly to support US diplomacy. Unfortunately, all this policy does is force employees into denial and secrecy; not the useful type of secrecy, either, but a type of counterproductive deceit which hurts the country, the department, the workforce, and families.

@Michelle, et al. – Not all professionals are very professional, are they? I've had some bad encounters, too. However, I have to say that most counselors and doctors I've had were both professional and compassionate. Sometimes you have to keep looking, even though that's really the last thing you want to do, and you have precious little gas left to run on.

Ken, you've already received positive feedback from "John" and all the others in this thread, but let me add my own. This post helped me in my own life — not just in the abstract, but ~today~.

My own little life drama: I was diagnosed three years ago with Type II Bipolar Disorder, pegged right up against the depressive side of the bipolar spectrum; basically, that means I have depression, but am immune to most medications. Until recently, I was leaning on my PhD advisor's understanding, dragging out my years as a graduate student while I went through treatment. This year, though, that advisor left academia with almost no warning, and the department isn't pleased to have a hanger-on student who just passed the seven-year mark on a five-year program. I have mere months, if not weeks, to wrap this dissertation up.

I'm almost not able to do it — yesterday, in fact, I didn't; I didn't leave the house and almost didn't leave bed. And the real problem is exactly what you said: it isn't THIS challenge that is actually holding me down; it's the thought that the next challenge, and the one after that, will be just as crippling. Why should I bother?

You reminded me that there is hope — not just that I'll finish this damn thing, but that I'll be able to build a life and a career free of this misery. Today, at least, I won't be going back to bed. Thank you.

He expressed a sentiment that I also experienced as a powerful deterrent to getting help: the fear that medication, or hospitalization, and therapy somehow mark you as other and lead to the end of your plans and ambitions forever. It's not true.

I lived with this fear for ages and it nearly destroyed my life. It kept me from getting treatment all through high school, until in my senior year, the point was mooted because the illness I avoided treating forced me to withdraw and my plans for the future vanished. When I finally stopped drifting and clawed my way back, the trajectory of my life was forever altered. I've fought my way to a place I can sustain, have been gainfully employed for 8 years, and now at 30 I have been accepted to an undergraduate program to continue my education. I struggle daily with the fear I won't be able to meet deadlines, that my feelings of listlessness, now less intense but always waiting at the margins, will prevent me from completing assignments or getting out of bed to attend classes. I'm considering real treatment and medication, but I've been terrified of the possible consequences, particularly as I have always aspired to take up the family business in law and I have been warned repeatedly that a history of medication or institutionalization could prove to be a hurdle in the "character & fitness" qualifier that accompanies the bar in my state (OH).

Coincidentally, my fiancee has just graduated law school, in spite of her own similar history. She has sought treatment and, at a low point, was institutionalized, but she is in a much better place mentally than she was before, in spite of serious setbacks, including a serious physical illness and the recent death of her father. However, she too has been told how her history might prove a barrier to her entering the occupation and as a result she's yet to apply for the character & fitness review (though law students in this state are encouraged to do so as 1L's) because rejection may in some circumstances result in a life-time ban from resubmitting.

I'm fully aware that your state is not mine and we'll have to give careful consideration to where she, and at some time later, I, decide to take the bar, but your openness about your struggles and your success in spite of them has given both her and me tremendous encouragement in dealing with our trepidation. I have decided that I will seek treatment and worry about the stigma later, because the consequences of inaction have already cost me too much. Your candor and example have helped me with that realization and I wanted to thank you for that.

Bad enough a struggle with the noonday demon, but struggling silently or alone because you've been dismissed by "helpers", or because disclosure can damage you professionally or personally, that breaks my heart.

Ken and Commenters – Thank you for your bravery. Reading your articles (more specifically this one) actually got me back into the therapy I desperately needed. I was raised to believe that psychology/therapy/psychiatry was all Quackery, and that it's shameful to feel the need to seek out a therapist. Just deal with it, etc. Needless to say, I'm surrounded by narcissists and enablers so the shame makes a ton of sense. I've pulled through a lot of things in my life, and if I hadn't read this and reached out for help I'm certain that I'd have gotten sick or gone back to old, bad habits. I've survived the rigors mental illness, suicide attempts, self-harm, and a gender transition. I won't lose, not for everything I've fought for.

Thanks for the reminder that it's okay to ask for help. I implore others in the same/similar situation to seek help as well.

I've had moderate success in similar circumstances by being extremely upfront about the issue and painting it as a positive rather than treating it like something you have to explain and justify. Unlike generic attorney #14 who went before you the challenges that you are going to have to deal with have been identified and managed – you've shown that you have a level of self awareness to recognize a problem, have gotten appropriate help, and (hopefully) built yourself a support network to help you spot and manage any potential flareups in the future. Generic attorney #14 however has coasted so far and no one knows how she'll cope when the stress of the profession starts pressing down on her – maybe she'll take up start drinking or smoking up, maybe she'll have a breakdown, or maybe she'll manage it in a healthy way and take up kickboxing or yoga – but at this point her fracture points and coping strategies are unknowns. Treat it as a source of strength that will help you to understand and deal with clients who have mental health challenges (particularly relevant if you are going into criminal law) and the odds are that someone on the committee assessing you has had mental health issues themselves or a family or friend who has struggled the ought to give them some sympathy and respect.

Here's what I can't figure out: all these people who are just as broke as I am, at risk of losing everything the same as me, who have to decide between groceries and rent this month, just like me…

…and then they asked for help, and they're getting better.

HOW?

I have serious medical problems I can't get help with. There is sure as hell no way I'll get any help for depression. When I could afford a doctor, I told her about it and she gave me referrals that I could never afford, and Valium to hold me over until the referrals.

I can't end it because there are two people in my life who don't deserve that. I can't go on. And I sure as hell can't get help. How do all these other people do it?

It's crazy to have incentives against mental health treatment for people with security clearances. It would make more sense to require all of them to have routine mental health "checkups," just like they get for their hearts and colons, with whatever follow up care is needed.

Very few people are mentally ill in such a way that even with treatment they can't continue in a sensitive position, but anyone (except sociopaths, I suppose) could be knocked off track by one of the normal events of life that cause humans to feel despair.

Ah, the Character and Fitness test. That had been a worry of mine (what isn't a worry of mine? I have anxiety issues!), and I have so far resisted getting professional help. I'm coping, I'm OK, there's no need to do something drastic/expensive/stressful like going to a doctor. It's not a necessity for me at this point, but I know I'll probably do so much better if I get this treated ASAP. But there are so many reasons not to, and C&F is one of those. It shouldn't be, but it is.
However, I found out a couple days ago that our state's bar association has a program to help lawyers and law students with depression/anxiety/drug addiction/personal shit that might affect professional shit. It's confidential, and one of the things they do is help students mitigate any C&F difficulties that might arise from these issues. I have not contacted them yet, but I'm keeping them in the back of my mind in case I get to a point where I either really need the help, or decide I'll do something now rather than wait until I really need it. Until then, I am decidedly on the fence (pun intended) with no plans of shifting position.

I don't suffer from a mental illness (that I am aware of),. but I have had the occasion to try and talk with people who were in the grips of depression. Is there any advice you can offer us "normals"? Any specific track that you think might be effective?

Thank you for making it clear that whatever one does it is likely to be a long and difficult process. I've found the all too common polyanish (sp?) attitude of "Just ask for help we'll get you some prozac and things will be fine," not only condescending but actively harmful. Prozac does appear to be able to help some people but it's not a miracle cure and when everything doesn't immediately get brighter and easier the hope that was offered can too easily turn into despair.

Frankly, I think this overly polyanish attitude is usually more for the benefit of the person offering it so they can avoid facing hard facts about the level of effort (and perhaps thus the amount of support they should be expected to offer) overcoming/dealing with depression can require. Not that those who offer it don't have sincere motives or genuinely care but it's easy to fall victim to wishful thinking.

My wife is awfully brave. She also has schizoaffective disorder. Think of it as the network of neurons in your brain frying itself until you start thinking that the men in black are after you – and you're so terrified you'll bash yourself onto the wall until you pass out.

When we met, she was well-positioned for a career in law. Nowadays, waking before 10 is a struggle and she's pretty out of it until noon. On the bright side, after a few months in a few mental institutions, she went from stalking people in a park to prove the dark men were out to get her to perfectly sane with medication. [The real story is somewhat darker. She spent a while in the violent ward.] Her IQ also dropped probably 20-30 points. Her family pretty much disowned her – they don't like the mentally ill.

But, she still gets up in the morning and tries to make a life for herself. I thought about it – I don't think I could. I can understand that there are real reasons to stigmatize at least some of the mentally ill. [Living with her prior to medication was too disturbing to be a horror movie.] The people who think it's her fault somehow – and that she should just think different – those people tick me off.

On the bright side, I can say that the NY area has excellent mental health availability, even for people without funds. Also, in practice, for therapy at least, it is possible to use insurance to go to a therapist to 'work through personal issues' or somesuch without getting a diagnosis. Also, if standard antipsychotics aren't helping, try clozapine.